Text-message responsiveness to blood glucose monitoring reminders is associated with HbA 1c benefit in teenagers with Type 1 diabetes

To evaluate an 18-month text-messaging intervention in teenagers with Type 1 diabetes and to assess factors associated with text responsiveness and glycaemic benefit. Teenagers with diabetes (N = 147), aged 13-17 years, received two-way text reminders at self-selected times to check blood glucose le...

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Bibliographic Details
Published in:Diabetic medicine 2019-05, Vol.36 (5), p.600-605
Main Authors: McGill, D E, Volkening, L K, Butler, D A, Wasserman, R M, Anderson, B J, Laffel, L M
Format: Article
Language:English
Subjects:
Adolescent
Adolescent Behavior
Attitude to Health
Blood Glucose - analysis
Blood Glucose Self-Monitoring - statistics & numerical data
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - epidemiology
Diabetes Mellitus, Type 1 - therapy
Female
Glycated Hemoglobin A - analysis
Humans
Male
Patient Participation - statistics & numerical data
Reminder Systems - standards
Reminder Systems - statistics & numerical data
Text Messaging - standards
Text Messaging - statistics & numerical data
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Summary:To evaluate an 18-month text-messaging intervention in teenagers with Type 1 diabetes and to assess factors associated with text responsiveness and glycaemic benefit. Teenagers with diabetes (N = 147), aged 13-17 years, received two-way text reminders at self-selected times to check blood glucose levels and reply with blood glucose results. At baseline, the participants (48% boys, 78% white, 63% pump-treated) had a mean ± sd age of 14.9 ± 1.3 years, diabetes duration of 7.1 ± 3.9 years and HbA concentration of 69 ± 12 mmol/mol (8.5 ± 1.1%). The mean proportion of days with ≥1 blood glucose response declined over time (0-6 months, 60 ± 26% of days, 7-12 months, 53 ± 31% of days, 13-18 months, 43 ± 33% of days). Over 18 months, 49% responded with ≥1 blood glucose result on ≥50% of days (high responders). Regression analysis controlling for baseline HbA revealed no significant change in HbA from baseline to 18 months in high responders (P = 0.54) compared with a significant HbA increase in low responders (+0.3%, P = 0.01). In participants with baseline HbA ≥64 mmol/mol (≥8%), high responders were 2.5 times more likely than low responders to have a clinically significant [≥5.5 mmol/mol (≥0.5%)] HbA decrease over 18 months (P 
ISSN:0742-3071
1464-5491
DOI:10.1111/dme.13929